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实时动态血糖监测与非强化糖尿病治疗中事件减少相关。

Flash CGM associated with event reduction in nonintensive diabetes therapy.

机构信息

Diabetes and Obesity Care, 185 SW Shevlin Hixon Dr, Ste #111, Bend, OR 97702. Email:

出版信息

Am J Manag Care. 2021 Nov 1;27(11):e372-e377. doi: 10.37765/ajmc.2021.88780.

Abstract

OBJECTIVES

We evaluated the effects of acquiring a flash continuous glucose monitoring (CGM) system in the population with type 2 diabetes (T2D) treated with basal or noninsulin therapy.

STUDY DESIGN

This was a retrospective database analysis of the IBM MarketScan Commercial Claims and Medicare Supplemental databases that assessed rates of acute diabetes-related events (ADEs) and all-cause inpatient hospitalizations (ACHs) in a large population with T2D treated with basal insulin therapy or noninsulin medications. ADE and ACH rates 6 months prior to and 6 months post CGM acquisition were compared.

METHODS

Inclusion criteria for analysis were diagnosis of T2D; age 18 years or older; treatment with long-acting, neutral protamine Hagedorn, or premixed insulin or noninsulin therapy; naïve to CGM; and acquisition of their flash CGM system between October 2017 and March 2019. Patients served as their own controls. Event rates were compared using weighted Cox regression with Andersen-Gill extension for repeat events.

RESULTS

A cohort of 10,282 adults with T2D (mean [SD] age, 53.1 [9.6] years; 51.9% male) who met inclusion criteria were assessed. ADE rates decreased from 0.076 to 0.052 events per patient-year (HR, 0.68; 95% CI, 0.58-0.80; P < .001). ACH rates decreased from 0.177 to 0.151 events per patient-year (HR, 0.85; 95% CI, 0.77-0.94; P = .002).

CONCLUSIONS

Acquisition of the flash CGM system was associated with significant reductions in outpatient and inpatient ADEs and ACHs. These findings provide compelling evidence that use of flash CGM in patients with T2D treated with basal insulin therapy or noninsulin therapy improves clinical outcomes and potentially reduces costs.

摘要

目的

我们评估了在接受基础或非胰岛素治疗的 2 型糖尿病(T2D)人群中获得 flash 连续血糖监测(CGM)系统的效果。

研究设计

这是对 IBM MarketScan 商业索赔和医疗保险补充数据库的回顾性数据库分析,评估了在接受基础胰岛素治疗或非胰岛素药物治疗的大量 T2D 患者中,急性糖尿病相关事件(ADE)和全因住院(ACH)的发生率。比较了 CGM 获得前 6 个月和获得后 6 个月的 ADE 和 ACH 发生率。

方法

分析的纳入标准为诊断为 T2D;年龄 18 岁或以上;接受长效、中性鱼精蛋白 Hagedorn 或预混胰岛素或非胰岛素治疗;对 CGM 无经验;并于 2017 年 10 月至 2019 年 3 月期间获得其 flash CGM 系统。患者作为自身对照。使用带有 Andersen-Gill 扩展的加权 Cox 回归比较重复事件的事件发生率。

结果

评估了符合纳入标准的 10282 名患有 T2D 的成年人(平均[标准差]年龄,53.1[9.6]岁;51.9%为男性)的队列。ADE 发生率从 0.076 降至 0.052 例患者-年(HR,0.68;95%CI,0.58-0.80;P < 0.001)。ACH 发生率从 0.177 降至 0.151 例患者-年(HR,0.85;95%CI,0.77-0.94;P = 0.002)。

结论

获得 flash CGM 系统与门诊和住院 ADE 和 ACH 显著减少相关。这些发现提供了有力的证据,表明在接受基础胰岛素治疗或非胰岛素治疗的 T2D 患者中使用 flash CGM 可改善临床结局并可能降低成本。

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